Antidote

We all like a good mystery, so we tend to overreact and over-personalize infectious threats that are truly remote. But with the so-called superbug, Methicillin Resistant Staph Aureus (MRSA), the story is somewhat different. This bacteria is nothing new—it's been around for decades—the media has simply dusted it off and given it a deadly new name. Which is not to say that the bug can't be deadly. Overuse of antibiotics breeds resistant strains of bacteria, including MRSA.
And perhaps most importantly, although the media is busy criticizing and undermining US drug companies for each unanticipated drug side effect, meanwhile, we don't have the antibiotics to combat the bacteria we do have. Well over a million people get infected in US hospitals every year, and hospital germs are increasingly resistant to multiple antibiotics (70% are resistant to at least one).

At the same time, the rate of production of new antibiotics has slowed dramatically, as the cost of developing a new drug has risen to over a billion dollars. We desperately need new antibiotics, but whereas in the 1990s more than 50 new antibiotics were in development at any given time, only 10 new antibiotics have been approved for use by the FDA in the past decade.

Why the drop off? First, antibiotic use is episodic, depending on an infection for its use, whereas so many of our other new medications are used daily and are more profitable. Second, hospital formularies tend to restrict the use of newer antibiotics. Third, the FDA has regulated drug approvals in this area with the onus on the drug company to prove its drug does something new.

Incentives must replace these disincentives, especially when it comes to targeting resistant bacteria. Instead of being automatically lambasted each time an unexpected side effect occurs, drug companies should be rewarded for coming up with new super drugs to treat the old resistant bacteria.

Marc Siegel, MD, is an internist and associate professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear


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